The objective of the proposed study is to test the effectiveness of virtual reality (VR) based interactive distraction for acute pain management in children. To accomplish this general goal, the proposed series of studies will: 1) Test whether the interactive nature of VR is a critical contributor to its effectiveness as a distractor during an acute laboratory pain experience (cold pressor); 2) Test whether interactive distraction is more effective in reducing cold pressor pain when provided via VR technology than when provided without the use of VR technology; 3) Test the effectiveness of VR distraction with a younger sample of children than has been used in the literature (i.e., a sample that includes 6-8-year-old children in addition to older elementary and middle school aged children); 4) Test whether findings obtained in the laboratory generalize to a clinical population of hematology patients by conducting a pilot test of VR distraction with Hematology-Oncology patients; and 5) Examine the role of child age and child anxiety as possible moderators of treatment outcome. Three studies are proposed. Study 1 tests interactive versus passive VR distraction during a laboratory cold pressor task. Sixty-six children will complete a baseline cold pressor trial and will then be assigned to one of the two experimental distraction conditions or to a control condition for the second cold pressor trial. Study 2 tests interactive distraction with and without VR technology with 90 children undergoing a laboratory cold pressor task. A 3 (experimental group) by 2 (cold pressor trials trials) mixed design similar to Study 1 will be used. In both studies, children are expected to demonstrate improvements in pain tolerance, pain threshold, and perceived pain intensity during the distraction conditions. However, in study 1, interactive VR distraction is expected to be superior to passive VR distraction. In Study 2, interactive distraction with VR is expected to be superior to interactive distraction without VR. Study 3 tests the applicability of VR based interactive distraction to the clinical setting. A pilot sample of children undergoing repeated hematological procedures will receive interactive distraction with and without VR technology in an alternating treatments design. Self report of pain during medical procedures and overt behavioral distress are expected to be lower in both distraction conditions relative to baseline, with the greatest benefits evident when VR technology is used. [unreadable] [unreadable]